Individual
DR. GINA TERESE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
501 N 9TH ST, KALAMAZOO, MI 49009-6594
(269) 544-2952
Mailing address
8361 CHARLEVOIX ST, KALAMAZOO, MI 49009-3988
(269) 569-0683
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004126
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20782
SPECTERA
MI
01
—
90-0-C9-1227-0
BLUE CROSS BLUE SHIELD
MI
01
—
FO1579300
CLARITY VISION
MI
Enumeration date
10/06/2006
Last updated
09/10/2015
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